兔肺白念珠菌病CT表现与病理变化的关系

CT appearances and pathology of pulmonary candidiasis:a case control study

目的:通过动物实验探讨急性期肺白念珠菌病CT表现与病理学改变的关系。方法:24只新西兰大白兔随机分为实验组(n=21)及对照组(n=3),实验组通过经皮气管穿刺法建立兔肺念珠菌病模型,对照组用同样方法注入生理盐水。于接种后每隔1 d行胸部CT扫描,观察CT表现,并与病理改变进行对照。结果:成功建立13例兔肺念珠菌病模型,首次CT阳性表现出现于接种后2～10 d,包括实变影10例:其中小叶性分布6例,病理表现为肺泡炎性渗出;叶段性分布4例,病理表现为肺组织坏死或出血性渗出。磨玻璃影6例,多与其他征象并发,病理表现为出血或炎性渗出;结节影3例,聚集于支气管血管束周围,病理表现为肉芽肿性炎症。结论:原发性肺白念珠菌病急性期CT表现以实变影最多见,其次为磨玻璃影和结节影,各种征象可并发,不具特征性。

Objective：To analyze the correlation between CT appearances and pathological findings at acute stage pulmonary candidiasis in rabbits. Methods： Twenty-four New Zealand rabbits were randomly divided into experimental group and control group. Rabbits in the experimental group were inoculated with Candida albicans via percutaneous trachea puncture and those in the control groups were injected with normal saline via the same way. Chest CT scans were performed every other day from the day the inoculations were completed. The scan results were controlled with the pathological findings. Results; Pulmonary candidiasis model were confirmed in 13 rabbits. The early CT appearance of pulmonary candidiasis was found from the second day to the tenth day after inoculation. We found consolidation in 10 cases, including 6 sublobe consolidation （intra-alveolar exudates） and 4 lobe or section consolidation （pulmonary infarct or hemorrhage）. Ground-glass attenuation （hemorrhage or exudates） was found in 6 cases and often coincided with other CT signs. Nodules were found in 3 cases and often found surrounding the bronchovascular bundle （granulomatous inflammation）. Conelusion; Consolidation is the major CT findings of primary pulmonary candidiasis at acute stage, followed by ground-glass attenuation and nodules. Various signs can occur simultaneously with no specificity.